Individual
JENNIFER KLOTZ JUBULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
887 CONGRESS ST, SUITE 320, PORTLAND, ME 04102
(207) 662-5522
(207) 662-5527
Mailing address
301C US ROUTE ONE, SCARBOROUGH, ME 04074
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D0068961
MD
208000000X
Pediatrics Physician
MD19415
ME
2080P0208X
Pediatric Infectious Diseases Physician
Primary
MD19415
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332504100
—
MD
Enumeration date
03/01/2007
Last updated
10/08/2012
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